TRANSIT (LAND/SEA/AIR) INSURANCE QUOTATION
PROPOSER
Name
T/as
Trade
Sole Trader
Partnership
Limited
Trading Since
Territory
UK Only
UK & ROI
ROI Only
LOCATION
Address
Postcode
CONTACT DETAILS
Tel
Fax
Mob
Email
Web
SINGLE TRANSIT COVER
Confirm The Nature Of The Goods...
Goods Description
Packaging Description
Recipient Name/Address
Goods Value
Packages
0
1
2
3
4
5
Confirm The Journey...
Depature Date :
Arrival Date :
Town/Port & Country
Transit Method
Departure
Transit Method
Land
Sea
Air
Via
Transit Method
Land
Sea
Air
Via
Transit Method
Land
Sea
Air
Via
Transit Method
Land
Sea
Air
Destination
Financial...
* Is a letter of credit applicable?
Organisation :
Reference :
* Note: The insurer may require a copy of the "letter of credit"
ANNUAL TRANSIT COVER
Confirm The Nature Of The Goods...
Goods Description
Packaging Description
Value Of Annual Carryings
Maximum Value Any One Load
Methods Used :
Road :
Rail :
Air :
Sea :
Confirm Who Will Transport The Goods...
Using Your Own Vehicles
0
1
2
3
4
5
6
7
8
9
10+
How many vehicles are used
Using Independent Carrier/Haulier
Confirm The Territory Transported To...
UK ONLY
UK & ROI
UK & ROI & EU
UK & ROI & EU & OTHER
If "Other" give details of territory/s...
INSTALLATION
Is cover required at destination during installation?
If Yes, descide the installation process...
INSURANCE HISTORY
Required Date
Current Insurer
Policy Number
Premium
Current Broker
CLAIMS RECORD
Tick if any claim in last 5 years
Give claim details, types, dates :
OTHER INFORMATION
Telephone 02870325999 for assistance